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STAKEOUT

(working title only)

 

Contestant Application Form

 

 

 

FULL NAME:

 

ADDRESS:

 

 

 

POSTCODE:

NICKNAME:

 

PHONE (DAY):

 

PHONE (EVE):

MOBILE:

AGE:

DOB:

MARITAL STATUS:

CHILDREN:

 

OCCUPATION (if applicable):

 

ANY HEALTH PROBLEMS:

 

ANY DIETARY SPECIFICATIONS:

 

PREVIOUS TV EXPERIENCE (if any):

 

 

 

 

PLEASE STATE ANY DATES YOU ARE NOT AVAILABLE IN SEPTEMBER 2001

 

 

HOW DO YOU INTEND TO RAISE THE £250 STAKE MONEY?

 

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NAME AND CONTACT NUMBERS OF THE BACKERS YOU WILL BRING TO THE STUDIO:

(MAX 4)

1.

2.

3.

4.

WORK OR STUDY (CURRENT OR PREVIOUS):

 

 

We need to know about your work, hobbies and any incidents that have happened to you that may be of interest and can be used on the show.  Please avoid any story that revolves around alcohol.  If you have a qualification, or have won anything for sport or a hobby, do let us know.  Travelogues are always useful, especially if you have been to unusual places or have travelled a lot. 

HOBBIES/PASTIMES:

 

 

 

 

ACHIEVEMENTS:

 

 

 

 

 

 

INCIDENTS/STORIES/CONFESSIONS/EMBARRASSING MOMENTS:

 

 

 

 

 

 

HEROES:

 

 

 

 

VILLAINS:

 

 

 

 

FAVOURITE TV PROGRAMMES:

 

 

 

 

TV HATES:

 

 

 

 

 

PLEASE RETURN ASAP TO:

 

STAKE OUT CONTESTANT TEAM, PRODUCTION OFFICE B,

THE MAIDSTONE STUDIOS, VINTERS PARK, MAIDSTONE, KENT ME14 5NZ